痛泻要方加减联合西药治疗腹泻型肠易激综合征临床观察

[目的]观察痛泻要方加减治疗肠易激综合征(IBS)的临床疗效.[方法]将67例IBS患者随机分为2组,对照组32例口服曲美布汀200 mg/次、思密达1包/次,均3次/d;实验组35例,在对照组治疗的基础上加服痛泻要方;2组均治疗4周为1个疗程.[结果]实验组总有效率为88.6％,对照组总有效率为80.0％,2组比较,差异有统计学意义(P＜0.05).[结论]中药痛泻要方联合西药治疗IBS疗效明显,值得临床推广应用.     

健脾调肝法治疗肠易激综合征142例

笔者在1988年—1992年4月,应用泻肝补脾、舒肝健脾、健脾理气3法,统称健脾调肝法,治疗肠易激综合征(Irri-table bowel syndrome,简称IBS)142例,效果满意,报告如下:1 对象和方法1.1 对象 本组共142例,其中门诊患者137例,住院病例5例;男83例,女59例;年龄在19—53岁之间,平均36.5岁;病程最短3个月,最长21年,平均4.3年。1.2 临床表现 腹痛134例,腹泻129例,便秘与腹泻交替13例,伴粘液便62例。1.3 中西医分型 ①肝气郁滞为主型:相当于西医痉挛性结肠型,一般病程较短,症见腹痛则泻,泻后则舒,或便秘与     

调肝健脾法治疗肠易激综合征71例

笔者在 1993年～ 1998年 ,应用舒肝理气健脾法、健脾益气舒肝法、健脾舒肝并重法 ,统称调肝健脾法 ,治疗肠易激综合征 (Irritable bowel syndrome,简称IBS) 71例 ,效果满意 ,现报告如下。1　临床资料1.1　对象 :本组共 71例 ,均为门诊患者。其中男 42例 ,女 2 9例 ;年龄在 2 1岁～ 48岁之间 ,平均 37.6岁 ;病程最短2个月 ,最长 19年 ,平均 3.8年。1.2　临床表现 :腹泻 6 4例 ,腹泻与便秘交替 5例 ,伴粘液便 30例。1.3　中西医分型1.3.1　肝气郁滞型 :相当于西医痉挛性结肠型 ,一般病程较短 ,症见腹痛则泻 ,泻后则舒 ,或腹泻与便秘交替 ,嗳…     

中药煎剂保留灌肠治疗腹泻型肠易激综合征的护理

肠易激综合征（IBS）是一种具有特殊生理病理基础的独立的肠功能紊乱性疾病。它包括一组腹痛、腹胀、排便习惯和大便性状异常，持续或间歇发作，而又缺乏明显形态学和生化异常改变可解释的综合征。我们近年来采用中药煎剂保留灌肠治疗腹泻型IBS 60例，取得满意疗效，现总结报道如下。     

中药痛泻要方治疗肠易激综合征疗效的荟萃分析

目的:评价以痛泻要方(TXYF)为基础方的中药方剂(TXYFa)治疗肠易激综合征(IBS)的疗效.方法:通过对网上电子数据库、临床试验注册数据库、参考文献以及手工对相关会议检索的TXYF和TXYFa治疗IBS随机或半随机对照试验,对照组用西药、安慰剂或不治疗者的对象和数据进行荟萃分析.结果:31个临床试验涉及32个TXYFa符合入选条件而纳入研究.对所有纳入试验的数据分析显示TXFYa具有显著疗效(RR:1.30,95%CI:1.22-1.38,P<0.01).其中23个TXYFa(72%)分别与西药或安慰剂比较有显著疗效(P<0.05);11个和20个试验数据分别显示TXYFa显著改善IBS总体症状(RR:1.31,95%CI:1.23-1.40,P<0.01)和腹泻型IBS的相关症状(RR:1.33,95%CI:1.21-1.45,P<0.01).纳入试验的方法质量学评估均为低质量试验,倒漏斗图形显示不对称,提示存在发表偏畸.结论:痛泻要方的潜在疗效和安全性有待严格设计的随机、双盲、安慰剂对照试验加以证实.     

痛泻要方加味联合黛力新治疗肠易激综合征60例

目的:观察中药痛泻要方加味联合黛力新治疗肠易激综合征(IBS)的临床疗效.方法:将110例IBS患者随机分为观察组(n=60)和对照组(n=50),分别采用中药痛泻要方加味联合黛力新及单用中药痛泻要方加味治疗1 mo.观察两组有效率、不良反应.结果:观察组和对照组总有效率分别为100%,84%(P＜0.05).腹痛、腹胀、腹泻单项症状总有效率观察组分别为100%,96%,93%,而对照组分别为88%,81%,81%(P均＜0.05);便秘、黏液便总有效率观察组与对照组无显著差异60＞0,05).观察组治疗期间未发现明显不良反应.结论:中药痛泻要方加味联合黛力新能快速消除和改善患者腹痛、腹胀、腹泻等症状,显著提高临床治疗效果,无明显不良反应.     

逍遥煎剂对腹泻型肠易激综合征大鼠的治疗作用

[目的]观察逍遥煎剂对腹泻型肠易激综合征（IBS）大鼠的治疗作用。[方法]将48只大鼠随机分为6组，即正常组，模型组，曲美布汀组，逍遥煎剂小、中、大剂量组，每组8只，除正常组外各组均复制腹泻型IBS模型，2周后，加用相应的药物治疗，观察各组大鼠7、14d的稀便级、小肠墨汁推进百分率、结肠组织病理的变化。[结果]治疗后曲美布汀组，逍遥煎剂小、中、大剂量组大鼠稀便级均明显减少，治疗7d后，逍遥煎剂小、中、大剂量组与曲美布汀组比较，差异有统计学意义（P〈0．05）；治疗14d后，逍遥煎剂中、大剂量组与小剂量组比较，差异有统计学意义（P〈0．05）。曲美布汀组，逍遥煎剂小、中、大剂量组均能明显减少大鼠小肠墨汁推进百分率，逍遥煎剂大、中剂量组与曲美布汀组比较，差异无统计学意义（P〉0．05）。各组大鼠结肠黏膜无充血、水肿、溃疡，光学显微镜下观察无弥漫性炎症细胞浸润等组织学改变。[结论]逍遥煎剂对腹泻型IBS大鼠有显著的止泻作用。     

疏肝健脾法治疗肠易激综合征58例

肠易激综合征(IBS)是胃肠道最常见和典型的功能性疾病。笔者运用疏肝健脾法治疗58例,取得较满意的疗效,现报告如下。     

肠易激综合征与炎症性肠病

近年发现,炎症性肠病(IBD)患者发病早期或缓解期时常表现为肠易激综合征(IBs)症状,且IBD与IBS的临床表现具有一定的相似性。因而IBS与IBD的相关性受到广泛的重视。此文就IBS与IBD的发病机制及临床相关性予以阐述,以期为临床个体化治疗提供借鉴。     

肠易激综合征与肠黏膜异常

肠易激综合征（irritable bowel syndrome，IBS）是以腹痛或腹部不适，伴有大便性状改变和排便习惯改变为特征的功能性肠道疾病，是消化科常见的疾病之一。目前，IBS的发病机制尚不明确。肠道黏膜是机体接触外环境最大的部位，拥有丰富的神经、免疫、内分泌等感觉细胞，IBS患者肠道黏膜的变化对研究IBS的发病机制具有独特的意义。本文对近年IBS与肠黏膜异常的研究进展做一综述。     

肠易激综合征与饮食因素

肠易激综合征（irritable bowel syndrome,IBS）症状与饮食关系密切,饮食疗法是IBS的重要的治疗手段之一。饮 食疗法主要包括传统的饮食建议,低可发酵的低聚糖、二糖、单糖和多元醇（fermentable oligosaccharides, disaccharides,monosaccharides and polyols,FODMAPs）饮食,无麸质饮食(gluten-free diet,GFD）以及益生菌。文章重点 阐述了饮食因素与IBS发病的关系以及饮食管理在IBS治疗中的作用。     

Irritable bowel syndrome in young and elderly patients with stable asthma

BACKGROUND: It has been speculated that asthma and irritable bowel syndrome may share common pathophysiological processes. AIM: To estimate the prevalence of irritable bowel syndrome in young and elderly patients with stable asthma. PATIENTS AND METHODS: Sixty-five young (age < 60 years) and 66 elderly (age > or = 60 years) stable asthmatics, and 119 age-matched healthy volunteers were enrolled. In all participants, presence of irritable bowel syndrome, quality of life and psychological status were evaluated. RESULTS: The prevalence of irritable bowel syndrome in asthmatic group was higher than that in the control group (27.5% versus 16.8%; odds ratio, 1.8 [1.0-3.4]; p=0.04). The prevalence of irritable bowel syndrome was significantly higher in young asthmatics than in age-matched healthy controls (36.9% versus 20.3%; odds ratio, 2.2 [1.0-5.1]; p=0.04) and than in elderly asthmatics (36.9% versus 18.2%; odds ratio, 0.3 [0.1-0.8]; p=0.01). Logistic regression analysis identified the younger age (odds ratio, 2.1 [1.1-3.8]; p=0.01), and the presence of asthma (odds ratio, 1.9 [1.0-3.5]; p=0.03) as independent risk factors for irritable bowel syndrome in all participants after adjusting for gender. We also found impaired quality of life to be associated with the presence of irritable bowel syndrome and asthma in all participants after adjusting for age and gender. CONCLUSION: The prevalence of irritable bowel syndrome appears to be significantly higher in young asthmatics, but not in elderly asthmatics, compared to age-matched healthy counterparts. Potential pathogenic mechanisms of higher irritable bowel syndrome prevalence in young asthmatics need to be explained by further studies.     

Irritable bowel syndrome evaluation using computed tomography colonography

AIM To evaluate the morphology of the colon in patients with irritable bowel syndrome(IBS) by using computed tomography colonography(CTC).METHODS Twelve patients with diarrhea type IBS(IBS-D), 13 patients with constipation type IBS(IBS-C), 12 patients with functional constipation(FC) and 14 control patients underwent colonoscopy following CTC. The lengths of the rectosigmoid colon, transverse colon and the total colon were measured. The diameters of the rectum, sigmoid colon, descending colon, transverse colon, and ascending colon were measured.RESULTS The mean length of the total colon was 156.5 cm in group C, 158.9 cm in group IBS-D, 172.0 cm in group IBS-C, and 188.8 cm in group FC. The total colon in group FC was significantly longer than that in group C(P 0.05). The mean length of the rectosigmoid colon was 56.2 cm, 55.9 cm, 63.6cm, and 77.4 cm(NS). The mean length of the transverse colon was 49.9 cm, 43.1 cm, 57.0 cm, and 55.0 cm. The transverse colonin group IBS-D was significantly shorter than that in group IBS-C(P 0.01) and that in group FC(P = 0.02). The mean diameter of the sigmoid colon was 4.0 cm, 3.3 cm, 4.2 cm, and 4.3 cm(NS). The mean diameter of the descending colon was 3.6 cm, 3.1 cm, 3.8 cm, and 4.3 cm. The descending colon diameter in group IBS-D was significantly less than that in group IBS-C(P = 0.03) and that in group FC(P 0.001). The descending colon diameter in group FC was significantly greater than that in group C(P = 0.04). The mean diameter of the transverse colon was 4.4 cm, 3.3 cm, 4.2 cm, and 5.0 cm(NS).CONCLUSION CT colonography might contribute the clarification of subtypes of IBS.     

Irritable bowel syndrome

Conceptually, the irritable bowel syndrome (IBS) has been considered a brain-gut functional disorder, but this paradigm is under serious challenge. There is increasing evidence that organic disease of the gastrointestinal tract can be identified in subsets of patients who fulfil the Rome criteria for IBS. Evidence for subtle inflammatory bowel disease, serotonin dysregulation, bacterial overgrowth and central dysregulation continue to accumulate. The underlying causes of IBS remain to be adequately identified, but postinfectious IBS is a clear-cut entity. Furthermore, a genetic contribution to IBS also seems likely. Diagnosis continues to be based on the symptom profile and the absence of alarm features. A heightened awareness of coeliac disease masquerading as IBS is becoming accepted. Management remains largely based on symptomatic rather than on disease-modifying therapy, but this is likely to change in the near future. Here, recent advances in the pathophysiology and management of IBS are considered.     

食物敏感与肠易激综合征研究进展

肠易激综合征(irritable bowel syndrome,IBS)是一种以腹痛或腹部不适伴排便习惯改变为特征的功能性胃肠病,其症状反复,严重地影响了患者的生活质量.研究发现,食物可引发或加重IBS患者的症状,其实质即食物过敏和食物不耐受,但具体的发病机制尚未得到肯定,目前包括细菌"代谢‘毒物’假说"、"免疫或炎症反应假说"、"物理或化学刺激假说"等.因此食物因素在IBS发病中的作用越来越受到重视,成为当前研究IBS病因的热点之一,本文将对食物敏感及食物引发IBS的可能机制、检测方法及干预措施的研究进展作一综述.     

Irritable bowel syndrome: Pathogenesis,diagnosis, treatment,and evidence-based medicine

Irritable bowel syndrome(IBS)is a chronic and debilitating functional gastrointestinal disorder that affects9%-23%of the population across the world.The percentage of patients seeking health care related to IBS approaches 12%in primary care practices and is by far the largest subgroup seen in gastroenterology clinics.It has been well documented that these patients exhibit a poorer quality of life and utilize the health care system to a greater degree than patients without this diagnosis.The pathophysiology of IBS is not clear.Many theories have been put forward,but the exact cause of IBS is still uncertain.According to the updated ROMEⅢcriteria,IBS is a clinical diagnosis and presents as one of the three predominant subtypes:(1)IBS with constipation(IBS-C);(2)IBS with diarrhea(IBS-D);and(3)mixed IBS(IBS-M);former ROME definitions refer to IBS-M as alternating IBS(IBS-A).Across the IBS subtypes,the presentation of symptoms may vary among patients and change over time.Patients report the most distressing symptoms to be abdominal pain,straining,myalgias,urgency,bloating and feelings of serious illness.The complexity and diversity of IBS presentation makes treatment difficult.Although there are reviews and guidelines for treating IBS,they focus on the efficacy of medications for IBS symptoms usinghigh-priority endpoints,leaving those of lower priority largely unreported.Therefore,the aim of this review is to provide a comprehensive evidence-based review of the diagnosis,pathogenesis and treatment to guide clinicians diagnosing and treating their patients.     

肠易激综合征与神经免疫内分泌网络调控异常

肠易激综合征（IBS）与神经免疫内分泌网络调节之间的联系尚未明确。此文分别从神经系统异常、免疫系统异常、内分泌系统异常三个方面介绍该网络在IBS发病机制中的重要作用。     

Irritable bowel syndrome and chronic constipation: Fact and fiction

Irritable bowel syndrome(IBS) and functional constipation(FC) are the most common functional gastrointestinal disorders. According to the Rome ⅢCriteria these two disorders should be theoretically separated mainly by the presence of abdominal pain or discomfort relieved by defecation(typical of IBS) and they should be mutually exclusive. However,many gastroenterologists have serious doubts as regards a clear separation. Both IBS-C and FC,often associated with many other functional digestive and non digestive disorders,are responsible for a low quality of life. The impact of the media on patients' perception of these topics is sometimes disruptive,often suggesting a distorted view of pathophysiology,diagnosis and therapy. These messages frequently overlap with previous subjective opinions and are further processed on the basis of the different culture and the previous experience of the constipated patients,often producing odd,useless or even dangerous behaviors. The aim of this review was to analyze the most common patients' beliefs about IBS-C and CC,helping physicians to understand where they should focus their attention when communicating with patients,detecting false opinions and misconceptions and correcting them on the basis of scientific evidence.